Meningococcal - how real is the threat?

Meningococcal - how real is the threat?January 22, 2002

Meningococcal has rapidly become one of the most feared diseases in Australia over the past few years, largely due to a slight increase in the number of cases reported and excessive media attention. But as Jacqueline Head discovers meningococcal is not easily contracted, and following a few simple steps can dramatically reduce the risk.

What is meningococcal?

Meningococcal is a bacterium living in the back of the throat or nose of around 10 per cent of the population. These people are known as 'carriers' and generally do not display signs or symptoms of meningococcal.

However they can transfer the bacteria through sneezing, coughing, kissing, and sharing drinks or cigarettes.

Fortunately, meningococcus cannot survive for very long once it is outside the body, and it is therefore not easily passed on. Most people who contract the germ do so after prolonged, close or intimate contact with the carrier.

There does not appear to be one particular reason why a person may be carrying the germ, however its presence has been linked to lack of hygiene, overcrowding, dry weather.

Medical experts also believe that smoking, including passive smoking, can increase a person's chances of carrying or contracting the meningococcus bacterium.

Once a person has contracted the germ, it can take between two to ten days for the first symptoms to appear. After that the disease spreads quickly and ruthlessly, and there have been cases reported where death has occurred just 12 hours after the first symptoms have kicked in.

Symptoms:

Meningococcal disease is characterised by the following symptoms:

sudden, intense headache

fever

nausea

vomiting

photophobia (sensitivity to light)

stiff neck

Rapid circulatory collapse and a haemorrhagic rash are symptoms of meningococcal septicaemia, which is a less common but more severe form of the disease.

Meningicoccal can cause long-term damage, with some victims of meningococcal septicaemia undergoing amputation of their fingers, toes, hands, and feet, and in severe cases legs and arms. Meningococcal can also leave sufferers deaf of with permanent brain damage.

Incidence in Australia:

During the past eight years there has been a significant increase in the number of cases reported. Numbers have almost tripled from 2 per 100,000 in 1991, to 5 per 100,000 in 1999.

Last year there were 411 reported cases and 24 deaths.

Meningococcal epidemics move in eight-14 year cycles, suggesting that the number of cases in Australia is peaking. However New Zealand has been experiencing an epidemic of Type B meningococcal since 1990, with a rate of 13.3 per 100,000 reported in the year 2000.

Meningococcal is also more prevalent in winter and spring, when the weather is dry, and there is much less chance of contracting during hotter, wetter months.

The most common age group to contract the disease is zero to two year olds, however adolescents and young adults also appear to be at greater risk than people over the age of 25.

Worldwide around 1.2 million cases of bacterial meningitis are recorded each year, and around 10 per cent of these are fatal. Half the cases and just fewer than half the deaths are due to meningococcus. Most outbreaks and epidemics of the bacteria occur in sub Saharan Africa in what is known as the 'meningitis belt' including countries such as Mali, Sudan, Niger and Burkina Faso.

Prevention and Treatment:

A vaccine for meningococcal type C was released in Australia last November. However the vaccine protects against Type C only, which is the most rapidly acting form of the disease and accounts for around 40 per cent of cases in NSW and also the most common type to affect babies.

The vaccine, called Meningitec, is not yet government subsidised, meaning the cost is relatively high at around $70 a dose.

For children under 12 months three shots are required, each two months after the other. Older people only need to have one shot to be immunised.

Type C is also the more common form to affect adolescents.

Other precautions can be taken to help prevent contracting this rare but fatal disease, and fortunately they are extremely simple.

As saliva is the main way meningococcal is spread, the best way to combat the disease is by not sharing drinks or cigarettes.

Only recently five young adults in Tasmania died due to meningococcal Type C, after they had been out in local nightclubs. All five had contracted the disease due to sharing drinks and cigarettes.

If a person suspects they have meningococcal disease, antibiotics such as penicillin are often administered immediately, even before diagnostic tests have been carried out.

Often public health workers will also try to identify the person carrying the germ, and then treat anyone who has been in contact with the carrier with prophylactic antibiotics in the hope of preventing an epidemic. The carrier is also treated to ensure the germs cannot be spread from them again.

Although incidence is rare, if you or your child displays symptoms such as an unexplained rash, fever, stiffness of the neck or lethargy - the name a few - make sure you seek medical treatment immediately.

References: World Health Organisation www.who.int

Guidelines for the Early Clinical and Public Health Management of Meningococcal Disease in Australia

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